In the District of Columbia, your healthcare agent’s authority begins when a physician determines you are unable to make or communicate your own medical decisions. You remain in control as long as you’re able to do so, but if you’re incapacitated, your agent steps in.

As a healthcare power of attorney lawyer in DC, I guide clients through selecting the right agent and preparing a document that ensures hospitals and healthcare providers understand who has the legal authority to decide.

Appointing a Healthcare Agent: What to Consider

The person you name as your agent should be ready and able to make tough decisions. More importantly, they should have a clear understanding of your wishes. This requires honest, even difficult, conversations about possible scenarios: terminal illness, coma, life support, spiritual support, and quality-of-life concerns.

Once your healthcare POA is in place, the original should be kept by your agent, with copies shared with you, your doctor, and possibly your local hospital. While many healthcare providers and facilities offer their own forms, the best approach is to have a personalized document prepared with the help of a qualified attorney as part of your broader estate plan.

Advance Medical Directives: Clarifying Your Medical Wishes

The term medical directive is a general one—it refers to any legal instruction about your medical care if you become unable to communicate. Most often, medical directives come in two forms: the healthcare power of attorney and the living will.

The healthcare power of attorney appoints the person who will speak for you. The living will, by contrast, expresses your preferences about end-of-life care, particularly regarding life-sustaining treatment if you are in a terminal condition or a persistent vegetative state.

These two documents work together. Hospitals and medical professionals primarily follow the instructions of your healthcare agent. If your agent knows what you want—thanks to thorough conversations—they usually won’t need to consult your living will. In practice, hospitals do not police your agent’s decisions or cross-check them against the language in your documents. Your agent’s authority carries real weight.

That said, a living will can still play an important role. It provides backup guidance for your agent and may be useful if your agent is unavailable. However, a living will alone is not enough. If you haven’t named a healthcare agent, hospitals often involve legal counsel and may seek the appointment of a court-appointed guardian to make decisions for you—someone who may or may not know your wishes.

As a medical decision planning attorney in DC, I make sure your directives are not only legally sound, but also practical in real-life healthcare situations.

Living Wills and DNR Orders in DC

A living will allows you to express your wishes about medical treatment in specific end-of-life circumstances. If you’re permanently unconscious or terminally ill with no realistic chance of recovery, a living will may direct doctors to withhold or withdraw life-sustaining measures such as artificial respiration, tube feeding, or dialysis.

As a living will attorney in Washington DC, I help clients put their values into writing—clearly and effectively. It’s important to remember that you can revise or revoke your living will at any time while you have capacity.

Some people confuse living wills with do-not-resuscitate (DNR) orders. A DNR tells emergency responders and hospital staff not to perform CPR if your heart stops or you stop breathing. A living will, by contrast, applies only after you’ve been diagnosed as permanently unconscious or terminally ill. While many people can benefit from a living will, DNR orders are generally more appropriate for frail or seriously ill individuals where resuscitation would likely cause more harm than good.

MOST: DC’s Medical Order for Scope of Treatment

While advance directives and living wills are important planning tools, they are not medical orders—and healthcare providers are not always required to follow them in fast-moving clinical situations. To address this, many states have adopted medical order programs for patients who are seriously ill or frail. In the District of Columbia, that program is called MOST, which stands for Medical Orders for Scope of Treatment.

MOST functions similarly to what other states call POLST (Physician Orders for Life-Sustaining Treatment). It is a portable, standardized medical order signed by both a licensed healthcare professional and the patient (or their authorized representative). It provides clear, actionable instructions about the types of life-sustaining treatment a patient does or does not want if their condition worsens.

Unlike an advance directive, which provides guidance, a MOST form is an active medical order that must be followed by emergency personnel, hospitals, and other care providers. It is most appropriate for patients with advanced illness, chronic progressive conditions, or serious frailty.

In my role as an end of life planning attorney in DC, I often advise clients on whether a MOST form is appropriate for their circumstances—and how it should coordinate with their healthcare power of attorney and living will. While MOST is not a substitute for those legal documents, it complements them by providing real-time guidance to medical professionals in emergency situations.

If you or a loved one is facing serious illness or advanced age, I can help you prepare a clear and coordinated set of documents—including the healthcare power of attorney, living will, and the MOST form—to make sure your wishes are understood and honored across all care settings.

Why End-of-Life Planning Should Be Part of Your Estate Plan

If you already have a will or trust, don’t overlook the need for medical planning. A comprehensive estate plan should include tools to protect you while you’re still alive but unable to act. Without these documents, your loved ones may have no legal authority to help you—and may be forced to go to court.

As an elder law and estate planning attorney in DC, I help clients create plans that protect them in life and after death. That includes making sure your healthcare preferences are known, legally enforceable, and honored.

If you’re ready to take control of your medical future, schedule a consultation with an end of life planning attorney DC families rely on. I’ll help you create a plan that brings peace of mind—for you and the people who care about you.